Jerry Michael Jesseph

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01030317A Issued in IN

Practice address

901 W 1St St
Bloomington, IN 47403-2205

Phone

(812) 332-7277

Fax

(812) 332-0405

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jerry Michael Jesseph Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Angela R Marshall PSYD Inc

  • Clinical Psychologist
  • Bloomington, IN
  • NPI 1033394101
  NPD (past)
• Angela R Marshall PSYD LLC

  • Clinical Psychologist
  • Bloomington, IN
  • NPI 1639387590
  NPD (past)
• Beth Anne Baxter, RN/CS, LLC

  • Adult Medicine Physician
  • Bloomington, IN
  • NPI 1588845382
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952359523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "SMITHVILLE",
            "state": "IN",
            "postal_code": "474580096",
            "telephone_number": "812-824-8787",
            "fax_number": "812-824-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W 1ST ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032205",
            "telephone_number": "812-332-7277",
            "fax_number": "812-332-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEPH",
        "first_name": "JERRY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01030317A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "JESSEPH",
            "middle_name": "MICHAEL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Richards LLC
• Jennifer Spencer PHD HSPP PC
• Jennifer Steinmetz MSW LLC
• Amy Beth Jensen, WRAPAROUND
• Ronald C Jenson, DO
• John Paul Jesseph, M.D.
• David M Jette, NP
• Zach W Jetter, RBT
• Ying Jia, ACUPUNCTURIST
• Brenda Jimenez Damian, RN

• Surgery Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.